Assesssment Of The Short-term Effects Of Cardiac Resynchronization Therapy By Tissue Velocity Imaging

PART one Assesssment of the short-term effects of cardiac resynchronization therapy by tissue velocity imagingObjective To assess the short-term effects of cardiac resynchronization therapy by tissue velocity imaging(TVI) technique and routine echocardiography.Methods Tri-chamber pacemaker was implantated in eighteen congestive heart failure patients.Philips IE33 was used to measure left ventricular end-diastolic and end-systolic dimension,and volume before and one month after cardiac resynchronization therapy(CRT).Biplane Simpson's method was used to measure left ventricular ejection fraction(LVEF).3～4 cardiac cycles TVI 3 standard apical chamber images were acquired from each patient.Q-lab software was used to measure the standard deviation of the time to regional peak systolic velocity(Ts) of 12 LV segments in ejection phase(Ts-SD-12-ejection), the peak systolic velocity of peak S(Sm) and the peak velocity of post-systolic shortening(PSS).Result In diastolic and systolic phase,the LV dimension decreased[(77±9.4)vs(73.5±9.4)mm,P＜0.05],[(67.6±8.2) vs(63.2± 11.1)mm,P＜0.05],and the volume decreased in diastolic phase[(266±68) vs(228±59)ml,P＜0.05],the volume decreased 10%than before in systolic phase[(213±54)vs(160±60)ml,P＜0.05].Ejection fraction of left ventricular improved significantly after CRT[(21.2±4.5)vs(26.6±4.8)ml,P＜0.05]. The synchronization of left ventricular was better than before.Ts-SD-12 decreased[(48.4±17.87)vs(35.16±19.4)ms,P＜0.05],and.And Sm of every segment increased obviously[(1.76±0.74) vs(1.96±0.82)cm/s,P＜0.01]. The number of PSS decreased[37.96%(82/216) vs 26.39%(57/216),P＜0.05] and the velocity decreased[(2.27±1.15) vs(1.93±0.63) cm/s,P＜0.05].Conclusions Tissue velocity imaging was ameliorated technique for assessing the outcome of CRT.PART two Using dp/dt assessed the short-term effects of cardiac resynchronization therapyObjective To assess the short-term effects of cardiac resynchronization therapy by using routine echocardiography and dp/dt estimated from mitral regurgitation.Methods Eleven congestive heart failure patients with mitral regurgitation were elected from eighteen patients after cardiac resynchronization therapy(CRT),and Philips IE33 was used to measure left ventricular end-diastolic and end-systolic dimension,and volume,and area of mitral regurgitation before and one month after cardiac resynchronization therapy.Biplane Simpson's method was used to measure left ventricular ejection fraction(LVEF).The maximal rate of LV pressure rise(dP/dt) was estimated by measuring the time interval between 1 and 3 m/s on the mitral regurgitation continuous-wave Doppler spectrum.Result In diastolic and systolic phase,the LV dimension decreased[(80.3±8.1) vs(79.3±9.9) mm,P＜0.01],[(71.2±8.1) vs(66.7±10.6) mm,P＜0.01],and the volume decreased 15%than before[(281±61) mm vs(242±57) mm,P＜0.01],[(228±47) vs(180±48) mm,P＜0.01]. Ejection fraction of left ventricular improved significantly[(20.7±4.6) vs(28.5±8.7)%,P＜0.01].The area of mitral regurgitation decreased[(8.1±3.8) vs(6.3±3.4)mm~2,P＜0.05],and dp/dt decreased obviously[(446±129) vs(591±134)mmHg/s,P＜0.01].Conclusions Dp/dt using mitral regurgitation was ameliorated technique for assessing the outcome of CRT.